By Mayo Clinic Staff
Pediatric obstructive sleep apnea is a sleep disorder that occurs when your child's breathing becomes partially or completely blocked repeatedly during sleep. The condition is due to narrowing or blockage of the upper airway during sleep.
There are some differences between pediatric obstructive sleep apnea and adult sleep apnea. Children often have only partially narrowed airways rather than a complete blockage as often seen in adults.
Obesity is a common factor underlying obstructive sleep apnea in adults. But in children the most common condition leading to obstructive sleep apnea is enlarged tonsils and adenoids.
Problems with daytime behavior and attention span are also common in children with OSA.
Expertise and experience. Mayo Clinic doctors who treat children for pediatric obstructive sleep apnea are pediatricians and pediatric subspecialists with extensive expertise in sleep medicine.
Pediatric sleep services are offered through the Center for Sleep Medicine at Mayo Clinic's campus in Minnesota. The Center for Sleep Medicine is fully accredited by the American Academy of Sleep Medicine and staffed by specialists, nurses and technologists trained in management of sleep disorders. Mayo Clinic doctors see about 450 children with obstructive sleep apnea each year.
- Team approach. A team of doctors trained in treating children (pediatricians), brain and nervous system conditions (neurologists), heart and blood vessel conditions (cardiologists), lung and breathing conditions (pulmonologists), mental health conditions (psychiatrists and psychologists), and pediatric ear, nose and throat conditions (otorhinolaryngologists), as well as doctors trained in dental specialties (orthodontists and dentists) and oral and maxillofacial surgery will work together to diagnose and treat your child. The multidisciplinary nature of the team means doctors can manage children with neurodevelopmental disorders, including Down syndrome, Prader-Willi syndrome and cerebral palsy.
- Research. Mayo Clinic doctors and researchers study new diagnosis and treatment options for pediatric obstructive sleep apnea and other sleep disorders and may participate in clinical trials.
Mayo Clinic in Rochester, Minn., ranks No. 1 for respiratory disorders and for neurology and neurosurgery in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Rochester, Minn., is ranked among the Best Hospitals for heart and heart surgery, for psychiatry, and for ear, nose and throat by U.S. News & World Report. Mayo Clinic also ranks among the Best Children's Hospitals for neurology and neurosurgery, for respiratory disorders, and for heart and heart surgery.
Pediatricians work with doctors trained in sleep medicine and other specialists to diagnose children with pediatric obstructive sleep apnea.
To diagnose your child's condition, your doctor will review your child's symptoms and medical history and conduct a physical examination. Because pediatric obstructive sleep apnea diagnostic tests and treatments differ from that of adults, it's important to obtain an accurate diagnosis.
Your child's doctor may also order several tests to diagnose pediatric obstructive sleep apnea.
Tests may include:
- Polysomnogram. Doctors may evaluate your child's condition during an overnight sleep study at the Center for Sleep Medicine at Mayo Clinic's campus in Minnesota. A sleep study (polysomnogram) uses sensors applied to the surface of the body to record brain wave activity, breathing patterns, snoring, oxygen levels, heart rate and muscle activity while your child sleeps.
- Oximetry. If doctors strongly suspect obstructive sleep apnea, and a full polysomnogram is not needed, an overnight recording of oxygen levels in the home setting may help make the diagnosis. Sometimes the oximetry test fails to give the diagnosis, in which case your child will need to have a polysomnogram.
- Electrocardiogram. In an electrocardiogram, sensor patches with wires attached (electrodes) measure the electrical impulses given off by your child's heart. Doctors may use this test to determine if your child has an underlying heart condition.
Your doctor will work with you to find the most appropriate treatment for your child's sleep apnea. To treat pediatric obstructive sleep apnea, your doctor may recommend the following:
- Avoid airway irritants and allergens. Children with pediatric obstructive sleep apnea should avoid tobacco smoke or other indoor allergens or pollutants, as they can cause airway irritation and congestion.
- Medications. Topical nasal steroids, such as fluticasone (Flonase) and budesonide (Rhinocort), may ease sleep apnea symptoms for some children. For kids with allergies, montelukast (Singulair) may help relieve your child's symptoms when used alone, or in combination with nasal steroids.
- Removal of the tonsils and adenoids (adenotonsillectomy). Your doctor may refer your child to a pediatric ear, nose and throat specialist to consider the removal of your child's tonsils or adenoids. An adenotonsillectomy (ad-uh-no-ton-sil-EK-tuh-me) may improve your child's obstructive sleep apnea by opening up the airway. Other forms of upper airway surgery may be recommended, based on the child's condition.
- Positive airway pressure therapy. In continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BPAP), small machines gently blow air through a tube and mask attached to your child's nose, or nose and mouth. The machine sends air pressure into the back of your child's throat to keep your child's airway open. Doctors often treat pediatric obstructive sleep apnea with positive airway pressure therapy.
- Weight loss. Doctors may recommend that your child lose weight if he or she is obese, as obesity is one of the causes of breathing problems in pediatric obstructive sleep apnea. Your doctor may provide you and your child with diet and nutrition information, or refer your child to other specialists with expertise in managing obesity.
- Oral appliances. Oral appliances, such as dental devices or mouthpieces, move your child's bottom jaw and tongue forward to keep your child's upper airway open. Mayo Clinic dental specialists have experience developing oral appliances to treat sleep apnea. Only some children benefit from such devices.
Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.
Doctors from the Center for Sleep Medicine at Mayo Clinic in Minnesota diagnose and treat children with pediatric obstructive sleep apnea.
For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.
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Mayo Clinic doctors actively research the causes and treatment of pediatric obstructive sleep apnea. Researchers study the effectiveness of diagnostic tests and treatments for children with pediatric obstructive sleep apnea. Learn more on the Center for Sleep Medicine and neurology research websites.
See a list of publications by Mayo doctors on pediatric sleep disorders and other sleep disorders on PubMed, a service of the National Library of Medicine.
Sept. 24, 2015
- Flint PW, et al. Pediatric obstructive sleep apnea. In: Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. https://www.clinicalkey.com. Accessed July 7, 2015.
- Tapia IE, et al. Newer treatment modalities for pediatric obstructive sleep apnea. Paediatric Respiratory Reviews. 2013;14:199.
- Rosen GM. Mechanisms and predisposing factors for sleep related breathing disorders in children. http://www.uptodate.com/home. Accessed July 7, 2015.
- Find an AASM-accredited sleep facility. American Academy of Sleep Medicine. http://www.sleepcenters.org/. Accessed July 10, 2015.
- Riggs EA. Decision Support System. Mayo Clinic, Rochester, Minn. April 17, 2015.
- Alexander MS. Pediatric obstructive sleep apnea syndrome. Pediatric Clinics of North America. 2013;60:827.
- Paruthi S. Management of obstructive sleep apnea in children. http://www.uptodate.com/home. Accessed July 7, 2015.
- Kotagal S. Sleep in neurodevelopmental and neurodegenerative disorders. Seminars in Pediatric Neurology. 2015;22:126.